My career goal is to be an international leader in patient oriented research that directly improves the lives of people with interstitial lung disease I am currently an Associate Professor at the University of California San Francisco (UCSF) with a strong institutional commitment to my success as a clinical researcher; I have developed an independent research career that is well funded by the NHLBI; I have established a productive and impactful research group with a large number of original research publications and a strong record of collaboration; and I have become a sought-after mentor in the field of interstitial lung disease with a steady stream of early investigators (from UCSF and around the world) who want to come work with me. I believe I am at an ideal stage in my career for a K24 award. With the support of this K24, I plan to devote substantial effort to mentorship and mentorship-related research activities. My approach to mentorship and mentee development is based around three core components: Establishing realistic goals for the mentee; Identifying the opportunities, knowledge and skills necessary to achieve the mentee's goals; and Providing adequate interaction, direction, and resources to insure that mentee's take advantage of these opportunities, knowledge and skills to progress toward his or her goals. Importantly, I tailor my mentee development program to the goals and experience level of each mentee. UCSF is one of the nation's leading academic medical centers, and it has an extensive infrastructure to support patient oriented research. The foundation for UCSF's institutional support includes a longstanding K30 Clinical Research Curriculum award (1999 to present) and a Clinical and Translational Science Award (CTSA, 2006 to present). Together, the K30 and CTSA awards provide essential infrastructure, services, and training to support patient oriented research and mentorship. The UCSF Division of Pulmonary, Critical Care, Sleep and Allergy, and the UCSF Department of Medicine are fully committed to my research career development and to supporting mentorship of patient oriented researchers. This award will support two new patient oriented research projects, both leveraging my existing NHLBI-funded research projects. The first involves a novel approach to outcome measurement in clinical trials of idiopathic pulmonary fibrosis (IPF) - the use of home monitoring. The second extends our research on risk prediction in IPF to investigate the additive value of blood-based biological markers to a validated clinical risk prediction model. Project 1 utilizes a novel approach (home-based assessment) to measure two key outcome measures in patients with IPF (forced vital capacity and dyspnea) that will refine our understanding of the natural history of IPF. I anticipate that home-based measurement of forced vital capacity and dyspnea severity will be well- tolerated, reproducible, and well-correlated with office-based measurements. Further, I expect home-based assessments to identify potential acute worsenings of disease more quickly than office-based assessments, and demonstrate that many patients with IPF have sub-clinical episodes of acute worsening. Project 2 builds upon seminal work from our group in the field of mortality risk prediction in IPF to look at important pre-mortality measures of disease activity and progression. Baseline values of blood-based biological markers will be added to the baseline clinical risk prediction model (GAP model) and the additive predictive value determined. I anticipate that the addition of blood-based biological markers will improve predictive performance of the GAP model substantially. This will provide an important tool to clinical researchers (and potentially, clinicians) looking to understand what individual patients are likely to experience over the subsequent 12 months.